Reuben D B, Frank J C, Hirsch S H, McGuigan K A, Maly R C
Multicampus Program in Geriatric Medicine and Gerontology, UCLA School of Medicine, Los Angeles, CA 90095-1687, USA.
J Am Geriatr Soc. 1999 Mar;47(3):269-76. doi: 10.1111/j.1532-5415.1999.tb02988.x.
Although comprehensive geriatric assessment (CGA) has been demonstrated to confer health benefits in some settings, its value in outpatient or office settings is uncertain.
To assess the effectiveness of outpatient CGA consultation coupled with an adherence intervention on 15-month health outcomes.
A randomized controlled trial.
Community-based sites.
363 community-dwelling older persons who had failed a screen for at least one of four conditions (falls, urinary incontinence, depressive symptoms, or functional impairment)
A single outpatient CGA consultation coupled with an intervention to improve primary care physician and patient adherence with CGA recommendations.
Medical Outcomes Study Short Form-36 (MOS SF-36), restricted activity and bed days, Physical Performance Test, NIA lower-extremity battery.
In complete case analysis (excluding the five control group subjects who died during the follow-up period), the adjusted difference in change scores (4.69 points) for physical functioning between treatment and control groups indicated a significant benefit of treatment (P = .021). Similar benefits were demonstrated for number of restricted activity days and MOS SF-36 energy/fatigue, social functioning, and physical health summary scales. In analyses assigning scores of 0 to those who died, these benefits were greater, and significant benefits for the Physical Performance Test and MOS SF-36 emotional/well being, pain, and mental health summary scales were also demonstrated.
A single outpatient comprehensive geriatric assessment coupled with an adherence intervention can prevent functional and health-related quality-of-life decline among community-dwelling older persons who have specific geriatric conditions.
尽管综合老年评估（CGA）已被证明在某些环境中对健康有益，但其在门诊或办公室环境中的价值尚不确定。
评估门诊CGA咨询结合依从性干预对15个月健康结局的有效性。
一项随机对照试验。
社区场所。
363名社区居住的老年人，他们在四项状况（跌倒、尿失禁、抑郁症状或功能障碍）中至少一项的筛查中未通过。
单次门诊CGA咨询，结合一项干预措施以提高初级保健医生和患者对CGA建议的依从性。
医学结局研究简明健康调查问卷（MOS SF-36）、受限活动天数和卧床天数、身体性能测试、美国国立衰老研究所下肢电池测试。
在完整病例分析（排除随访期间死亡的5名对照组受试者）中，治疗组和对照组之间身体功能变化评分的调整差异（4.69分）表明治疗具有显著益处（P = 0.021）。受限活动天数以及MOS SF-36能量/疲劳、社会功能和身体健康汇总量表也显示出类似益处。在将0分赋予死亡者的分析中，这些益处更大，并且身体性能测试以及MOS SF-36情绪/幸福感、疼痛和心理健康汇总量表也显示出显著益处。
单次门诊综合老年评估结合依从性干预可预防患有特定老年疾病的社区居住老年人的功能和与健康相关的生活质量下降。
